Asheber Hanna, Minhas Renu, Hatolkar Ved, Jaiswal Atul, Wittich Walter
DeafBlind Ontario Services, Newmarket, ON L3Y 3E3, Canada.
School of Optometry, Université de Montréal, Montreal, QC H3T 1P1, Canada.
Healthcare (Basel). 2024 Dec 6;12(23):2475. doi: 10.3390/healthcare12232475.
: The World Federation of the Deafblind Global Report 2023 reports that many countries do not have a comprehensive identification, assessment, and referral system for persons with deafblindness, a combination of hearing and vision loss, across all age groups and geographic regions. The scan seeks to inform researchers, policymakers, and community-based organizations about the status of and gaps in sensory healthcare initiatives in Canada, with the intent to raise awareness to enhance the integration and coordination of eye and ear care services. : We conducted an environmental scan of Canada's healthcare system and current public health policies addressing vision and hearing care in Canada at the federal and provincial levels. The scan was conducted using published literature searches from five scientific databases-Embase, Medline, PsycINFO, PubMed, and CINAHL-in combination with the gray literature review of federal, provincial, and territorial governments and non-profit organizations' websites from April 2011-October 2022. Out of 1257 articles screened, 86 studies were included that met the inclusion/exclusion criteria. In total, 13 reports were included in the gray literature search, with 99 total articles used in the analysis. : The thematic findings indicate stigma and discrimination toward individuals with disabilities and marginalized communities (Indigenous people, rural communities, recent immigrants, people of older age, and people with disabilities), including hearing, vision, or dual sensory loss, persist. Barriers to vision and hearing healthcare access include inadequate policies, underinvestment in vision and/or hearing services, limited collaboration and coordinated services between hearing and vision services, discrepancies in insurance coverages, and lack of health system support. : This scan demonstrates the persisting barriers to vision and/or hearing services present in Canada, stemming from inadequate policy and limited service coordination. Future work to address gaps, evaluate public education, and develop integrated sensory healthcare initiatives to enhance coordinated eye and ear care services, as recommended in the WHO Report on Hearing and Vision, is imperative.
《2023年全球失聪兼失明者联合会全球报告》指出，许多国家在所有年龄组和地理区域都没有针对失聪兼失明者（即听力和视力都有损失的人）的全面识别、评估和转诊系统。此次审视旨在让研究人员、政策制定者和社区组织了解加拿大感官保健举措的现状和差距，目的是提高认识，以加强眼耳保健服务的整合与协调。我们对加拿大医疗保健系统以及联邦和省级层面针对加拿大视力和听力保健的现行公共卫生政策进行了一次环境审视。此次审视通过在五个科学数据库（Embase、Medline、PsycINFO、PubMed和CINAHL）中进行文献检索，并结合对2011年4月至2022年10月期间联邦、省级和地区政府以及非营利组织网站的灰色文献回顾来开展。在筛选的1257篇文章中，有86项研究符合纳入/排除标准，被纳入研究。灰色文献检索共纳入13份报告，分析中总共使用了99篇文章。主题研究结果表明，对包括听力、视力或双重感官丧失者在内的残疾人和边缘化社区（原住民、农村社区、新移民、老年人和残疾人）的污名化和歧视依然存在。获得视力和听力保健的障碍包括政策不完善、对视力和/或听力服务投资不足、听力和视力服务之间协作与协调服务有限、保险覆盖范围存在差异以及缺乏卫生系统支持。此次审视表明，加拿大在视力和/或听力服务方面存在持续障碍，原因是政策不完善和服务协调有限。按照世界卫生组织关于听力和视力的报告中的建议，未来有必要开展工作以填补差距、评估公众教育并制定综合感官保健举措，以加强眼耳保健服务的协调。
